The comparison between extra-amniotic saline infusion and gemeprost as abortificient in mid-trimester silent miscarriage

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Date
2002-05
Authors
Ibrahim, Adibah
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Publisher
Universiti Sains Malaysia
Abstract
Extra- amniotic saline infusion (EASI) as abortifacient is not new, however it is still a safe abortifacient as quoted in the literatures. Gemeprost on the other hand is a popular abortifacient used widely however at exhorbitant cost. In this day and age when the price of health care is escalating some countries are considering cheaper altematjves. We at Hospital Kota Bharu wished to evaluate EASI as an alternative method of abortifacient. From 1st March 2000 till 28th February 2001 , 91 patients were randomly selected to two methods of abortifacient, Gemeprost 1 mg daily (wruch is the standard protocol in HKB) and EASI. Both methods were analysed and compared for effectiveness in terms of completeness of abortion and inductionabortion interval, adverse effects, duration of hospital stay and the cost of treatment and finally the patients' satisfaction of the treatment. Results: 54.8% of the patients receiving EASI had complete abortion as compared to 59.2% in the gemeprost group. The mean duration of induction- abortion interval was 12.76 hours in the EASI group and 10.24 hours in the gemeprost group. Both of these 2 end- results were not statistically significant. No difference in the duration of hospital stay and side- effects were noted. However, it is noted that using EASI is far cheaper than gemeprost, being RM 69.25 and RM183.30 respectively. Majority of the patients were satisfied with the treatment, however, 17% of the patients receiving EASI were not satisfied with the treatment, whilst none were noted in the gemeprost group. Recommendation: EASI is as effective as gemeprost as abortifacient in midtrimester silent miscarriage provided that the patients were initially explained regarding the expected discmfort. We recommend EASI as an alternative to gemeprost in selected patients especially in places where financial constrain is an important factor.
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Silent miscarriage
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